Day care sends sick kids home unnecessarily: study

NEW YORK (Reuters Health) - Child care centers are too prone to send toddlers home for mild illnesses, doctors say.

In a new survey of centers in Milwaukee, Wisconsin, directors said they would exclude kids more than half the time for minor ailments such as pink eye, ringworm or mild fever.

This is medically unnecessary and runs counter to long-standing professional guidelines, the researchers say.

By the time kids have symptoms, they've already been contagious, and "they've already done the damage," Dr. Andrew N. Hashikawa of the Medical College of Wisconsin in Milwaukee told Reuters Health. "It doesn't do any good to send these kids home."

He added that exclusion is "a significant burden for parents," who may be forced to take unpaid sick leave or scramble to find an alternative.

The findings square with earlier surveys from states that don't back the medical guidelines, first issued in 1992 by the American Academy of Pediatrics and the American Public Health Association. But Wisconsin endorsed the guidelines more than a decade ago, the researchers said in the journal Pediatrics.

For their survey, Hashikawa and colleagues interviewed 305 child care center directors. They presented them with five different scenarios in which a toddler had mild illness and asked what action the directors would take.

In each scenario -- a kid with a cold, a light fever, pink eye, ringworm, or loose stools -- the guideline recommendation was the same: No need to send the toddler home right away.

However, almost one-third of the directors chose to exclude the kid in four or all five of the cases. Overall, they ended up sending 57 percent of kids home unnecessarily.

"There are conditions where you'd obviously send a kid home," said Hashikawa. But, he added, "We found that oftentimes they are sent home when they really don't need to be."

Only a minority of center directors turned out to be familiar with the guidelines. "Directors have a tough job, they are working hard," said Hashikawa, "I think they just need more training."

Calvin Moore, Jr., president of the National Association for Family Child Care, which represents about 8000 centers across the country, agreed.

"We need more training and more technical assistance, and it should be part of the licensing requirements in each state," he said.